About this guidance
All children and young people* are entitled to protection from abuse and neglect. Good Medical Practice1 places a duty on all doctors to protect and promote the health and well-being of children and young people. This means all doctors must act on any concerns they have about the safety or welfare of a child or young person.
Child protection is a difficult area of practice that can involve making decisions that are emotionally challenging, complicated by uncertainty and sometimes go against the wishes of parents.† Doctors should work with parents and families, where possible, to make sure that children and young people receive the care and support they need. But in cases where the interests and wishes of parents may put the safety of the child or young person at risk, doctors must put the interests of the child or young person first.‡ Failure to act when a child or young person is at risk can have serious consequences for both the child and their family.
This guidance aims to help doctors to protect children and young people who are living with their families or living away from home, including those being looked after by a local authority.
In this guidance ‘abuse or neglect’ means physical, emotional or sexual abuse, including fabricated or induced illness, and emotional or physical neglect, which has led, or may lead, to significant harm to a child or young person.2,3,4
All doctors have a duty to keep up to date with, and follow, the relevant laws, codes of practice and guidance, including our advice in Good Medical Practice1 and 0–18 years: guidance for all doctors5 and our guidance on confidentiality6 and consent.7 These booklets provide more advice on assessing capacity, and making decisions about treatment relating to the health of children and young people.
In this guidance, the terms ‘you must’ and ‘you should’ are used in the following ways.
- ‘You must’ is used for an overriding duty or principle.
- ‘You should’ is used when we are explaining how to meet the overriding duty.
- 'You should’ is also used where the duty or principle will not apply in all situations or circumstances, or where there are factors outside a doctor’s control that affect whether or how a doctor can follow this guidance.
It is vital that all doctors have the confidence to act if they believe that a child or young person may be being abused or neglected. Taking action will be justified, even if it turns out that the child or young person is not at risk of, or suffering, abuse or neglect, as long as the concerns are honestly held and reasonable, and the doctor takes action through appropriate channels. Doctors who make decisions based on the principles in this guidance will be able to justify their decisions and actions if we receive a complaint about their practice.*
Footnotes
*This guidance is concerned with children and young people from birth until their 18th birthday (see the definitions of children, young people and parents of this guidance).
†References to ‘parents’ in this guidance include people who care for or look after children or young people. This might include carers, other family members or adults who live in the same household (see the definitions of ‘children’, ‘young people’ and ‘parents’ of this guidance).
‡See JD v East Berkshire Community Health Trust & Ors [2005] UKHL 23 (21 April 2005).
85. … The best interests of a child and his parent normally march hand-in-hand. But when considering whether something does not feel “quite right”, a doctor must be able to act single-mindedly in the interests of the child. He ought not to have at the back of his mind an awareness that if his doubts about intentional injury or sexual abuse prove unfounded he may be exposed to claims by a distressed parent.
87. This is not to say that the parents’ interests should be disregarded or that the parents should be kept in the dark. The decisions being made by the health professionals closely affect the parents as well as the child. Health professionals are of course fully aware of this. They are also mindful of the importance of involving the parents in the decision-making process as fully as is compatible with the child’s best interests...’
*As with all our guidance, serious and persistent failure to follow the advice in this guidance will put your registration at risk. For further information see how we handle complaints.